Form R-84 Final Disposition Report

R-84 (Rev.
11-1-20)
R-84
(Rev.12-1-20)
09-15-2017)
OMB-1110-0051

DISPOSITION REPORT
States
must ensure
ensure
dispositions
are
routed
through
their
state for
bureaus
for
submission
to the FBI.
State
must
be routed
through
State
Bureau
submission
to
the FBI.
State dispositions
Bureau
Requirements
mustare
be
met. your
States
must
dispositions
routed
through
their
state
bureaus,
when
applicable.
Email
completed
form
to to
[email protected]
(preferredClarksburg,
method), fax
to26306,
304-625-9896,
or mail to: 1000
Custer
Hollow
Road See
Clarksburg,
WVon
26306.
Forward
completed
form
FBI, CJIS Division,
WV
Email [email protected],
or Fax:
(304)
625-9896.
instructions
reverse side.

FBI Number (UCN)
StateIdentification
Bureau No. (SID)
State
No. (SID)
*Name on fingerprint card submitted to FBI
(Last, First, Middle)
*Date of Arrest
Offense(s) Charged at Arrest
*Submitting
Social Security No.
Agency ORI
Disposition Maintenance Required (see reverse for explanation):
Court
Charge
#

*Court Offense Literal (COL)
Charge at time of Disposition

*Date of Birth
Contributing/Arresting
Agency ORI
*Submitting Agency,
City, State

Add

Replace

Append (CPL only)

Felony
Felony,
Misd,
or or *Court Provision Literal (CPL)
Other
Misd
Disposition
_______

________________
Event Identifier
(EVI)
*Mandatory
Field
Event Indicator
(EVI)

Additional Court Charges and Dispositions can be added on reverse side of form.
*Mandatory Field
Additional Court Charges and Dispositions can be added on reverse side of form.

Event Indicator (EVI)

Delete

Relationship
to Victim

Is the
offense
drug
related?

INSTRUCTIONS
1. The purpose of this report is to capture the disposition of an arrest to complete an individual’s criminal history record information. The FBI number
(UCN) should be indicated, if known. Asterisk indicates mandatory field, but all known data should be provided.
2. If the arrest is disposed of by the arresting agency, as where the arrestee is released without charge, the arresting agency must complete this form. Of
2. Pursuant to 28 C.F.R. 20.37, every criminal justice agency submitting disposition information to the Federal Bureau of Investigation (FBI)
course, if the disposition is known when the arrest is submitted, it should be noted on the fingerprint submission and this form is then unnecessary. In the
is responsible for assuring accuracy, completeness, and currency of the records and must, to the extent possible, ensure that dispositions are
event the case goes to the prosecutor this form should be forwarded to the prosecutor with arrestee’s case file.
made available for all arrest data included on the individual's record. Dispositions should be submitted by criminal justice agencies within
3. The prosecutor should complete the form to show disposition at the prosecution level if the matter is not being referred for court action. If court action is
120 days after the disposition has occurred.
required, the prosecutor must forward form with case file to court having jurisdiction.
4. When
The court
complete
form as to or
final
courtguilty
disposition
such asorwhen
the arrested
is acquitted,
case is
dismissed,
theshould
arrested
personthis
is convicted
pleads
to a lesser
different
offenseperson
than when
originally
arrested,
thisconviction/sentence
information should
3.
imposed
or
suspended,
or
person
placed
on
probation.
be clearly indicated.
5. When the arrested person is convicted or pleads guilty to a lesser or different offense than when originally arrested, this information should be clearly
4. indicated.
Disposition Maintenance Requested explanation:
6. Disposition Maintenance Requested explanation:
datacourt
to DOA
a. Add
Add:disposition
Add new
charge number.
Ab. Replace:
Replace
existing court
charge number and associated COL and CPL.
RReplace existing
disposition
for a DOA
c. Append:
Append to
thetoCourt
Provision
Literal
the specified court charge number.
Append disposition
data
existing
disposition
dataonly
for afor
DOA
DA fillable R-84 Form is available for download at www.fbi.gov.
d. Delete:
Delete
existing court
charge
number (if exact match).
XDelete existing
disposition
data for
a DOA
Court
Charge
#

*Court Offense Literal (COL)
Charge at time of Disposition

Felony
Felony
or or *Court Provision Literal (CPL)
Misd,
Misd
Disposition
Other
________

Relationship
to Victim

Is the
offense
drug
related?

Paperwork Reduction Act Notice: According to the Paperwork Reduction Act of 1995, no persons are required to provide the information requested unless a valid
OMB control number is displayed. The valid OMB control number for this information collected is 1110-0051. The time required to complete this information
collected is estimated to be five minutes, including time reviewing instructions, gathering, completing, reviewing and submitting the information collection. If you
have any comments concerning the accuracy of this time estimate or suggestions for reducing this burden, please send to: Department Clearance Officer, United States
Department of Justice, Justice Management Division, Policy and Planning Staff, Washington, DC 20530